• Title/Summary/Keyword: 수술적 치료 결과

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Treatment Outcome of Thymic Epithelial Tumor: Prognostic Factors and Optimal Postoperative Radiation Therapy (흉선상피종의 치료 성적: 예후 인자 및 방사선치료 방법에 대한 연구)

  • Oh Dong Ryul;Ahn Yong Chan;Kim Kwan Min;Kim Jhingook;Shim Young Mog;Han Jung Ho
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.85-91
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    • 2005
  • Purpose : This study was conducted to analyze treatment outcome and prognostic significance of World Health Organization (WHO)-defined thymic epithelial tumor (TET) subtype and to assess optimal radiation target volume in patients receiving surgery and adjuvant radiation therapy with TET. Materials and Methods: The record of 160 patients with TET, who received surgical resection at the Samsung medical Center, from December 1994 to June 2004, were reviewed. 99 patients were treated with postoperative radiation therapy (PORT). PORT was recommended when patients had more than one findings among suspicious Incomplete resection or positive resection margin or Wasaoka stage $II\~IV$ or WHO type $B2\~C$. PORT peformed to primary tumor bed only with a mean dose of 54 Gy. The prognostic factor and pattern of failure were analyzed retrospectively. Results : The overall survival rate at 5 years was $87.3\%$. Age (more than 60 years $77.8\%$, less than 60 years $91.1\%$; p=0.03), Wasaoka stage (I $92.2\%$, II $95.4\%$, III $82.1\%$, IV $57.5\%$; p=0.001), WHO tumor type (A-Bl $96.0\%$, B2-C $82.3\%$; p=0.001), Extent of resection (R0 resection $92.3\%$, R1 or 2 resection $72.6\%$, p=0.001) were the prognostic factors according to univariate analysis. But WHO tumor type was the only significant prognostic factor according to multivariate analysis. Recurrence was observed in 5 patients of 71 Masoka stage I-III patients who received grossly complete tumor removal (R0, R1 resection) and PORT to primary tumor bed. Mediastinal recurrence was observed In only one patients. There were no recurrence within irradiation field. Conclusion : WHO tumor type was the important prognostic factor to predict survival of patients with TET. This study suggest that PORT to only primary tumor bed was optimal. To avoid pleura- or pericardium-based recurrence, further study of effective chemotherapy should be investigated.

Thin Split-Thickness Toe Nail-Bed Grafts for Nail Bed Defects in Subungal Exostosis: Two Cases Report (얇은 부분층 조갑상 이식을 통한 조갑하 외골종의 치료: 2예 보고)

  • Oh, In Suk;Kim, Chang Hee;Choi, Jong-Sun;Lee, Sang Hyeong
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.83-88
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    • 2012
  • We reviewed the clinical features of 2 patients who underwent surgery for subungal exostosis, focusing on postoperative deformity of the nail. The lesion destroyed the nail bed and was excised with a direct approach. then thin split-thickness sterile matrix graft was done after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by thin split-thickness sterile matrix graft. The use of thin split-thickness sterile matrix graft for the replacement of a nail bed defect can regain a smooth, adherent, and normal-looking nail and avoid donor-site morbidity. Thin split-thickness toe-nail bed graft is a good choice for the prevention of postoperative deformity.

Angiosarcoma of the Scalp : A Case Report and the Radiotherapy Technique (두피에 발생한 혈관육종 : 증례보고와 방사선치료방법에 대한 고찰)

  • Kim, Joo-Young;Choi, Jin-Ho
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.351-355
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    • 1998
  • Cutaneous angiosarcomas are uncommon malignancies which account about 1$\%$ of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed Photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed to the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7$\%$ of the prescribed dose by TLD readings.

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Partial thickness tear: Debris vs. Repair (회전근 개 부전층 파열: 변연절제술가 봉합술)

  • Oh, Jeong-Hwan;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.34-39
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    • 2005
  • Partial thickness rotator cuff tears (PTRCTs) are now a well-established clinical entity, yrt there is no consensus in regards to surgical management. Recommended treatment varies widely from simple debridement of the torn tendon to subacromial decompression to excision of the degenerative tendon and repair. Surgery may be performed using an open, arthroscopically assisted (miniopen), or entirely arthroscopic procedure. The advantages and disadvantages of open and arthroscopic procedures may lie in the balance between precision and morbidity. Visualization of both the articular and bursal surfaces is mandatory to determine the level of rotator cuff disease and formulate a treatment strategy. Because these tear often are secondary finding, recognition of the primary pathology is critical. Treatment of the primary problem usually remedies the partial tear. However, when there is significant PTRCT, an arthroscopic or open repair of the diseased tendon will give the most consistent results.

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Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion (신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kang, Tae-Soo;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.582-586
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    • 2007
  • A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.117-124
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    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Surgical orthodontic treatment of skeletal Class III malocclusion using mini-implant: correction of horizontal and vertical dental compensation (Mini-implant를 이용한 III급 부정교합의 수술교정치료: 수평, 수직적 치성 보상의 조절)

  • Im, Dong-Hyuk;Park, Hyun-Jung;Park, Jae-Woo;Kim, Jeong-Il;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.36 no.5
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    • pp.388-396
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    • 2006
  • Treatment of skeletal Class III malocclusion with mini-implant anchorage is discussed in relation to vertical control of the maxillary posterior dentoalveolar region and horizontal control of mandibular anterior teeth. A midpalatal mini-implant provided anchorage for intruding the maxillary posterior teeth. Mandibular mini-Implant implants were used to bring about labioversion of mandibular anterior teeth. After mandibular setback surgery, improvement of the facial profile was obtained both horizontally and vertically, Total treatment time was 11 months. Stable occlusion was maintained after 18 months of retention, The effectiveness and efficacy of mini-implants for the treatment of skeletal Class III malocclusion are also discussed.

Surgical Treatment of Bronchopleural Fistular Using Tissue Flap -4 Case Reports- (조직편을 이용한 기관지흉막루의 수술적 치료 -4례 보고-)

  • Choe, Deok-Yeong;Son, Dong-Seop;Jo, Dae-Yun;Yang, Gi-Min
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.792-797
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    • 1996
  • Empyema with bronchopleural fistula is a serious complication after resectional surgery of the lung. Several methods in treating empyema with bronchopleural fistula have been developed, but the results were not always satisfactory. Recently, successful results have been reported with the surgical treatments using tissue flap (the omentum and f or the chest wall muscles) to close the bronchopleural fistula in patients with thoracic empyema. We have performed surgical procedures to treat bronchopleural fistula using omentum in 1 patient an chest wall muscles in 3 patients. Their postoperative courses were uneventful.

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Surgical Management of Traumatic Cardiac Injury (외상에 의한 심장 손상의 수술적 치료)

  • 강준규;윤유상;김형태;박인덕;소동문;이철주
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.335-341
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    • 2004
  • Traumatic cardiac injury is very rare but mortality is very high when the diagnosis and management are delayed. We reviewed our case retrospectively. Material and Method: From March 1995 to July 2003, 17 patients were diagnosed as having traumatic cardiac rupture. Five patients were stabbed, seven patients were motor vehicle accidents, four patients had fallen down, and the cause was unknown in one patient. Emergency operations were done and six patients were operated under CPB. Result: Four patients died during or after operation. The mean ICU stay period was 3.86$\pm$3.35 days and the mean hospital stay was 18.27$\pm$14.99 days. No mortality was observed in those whose vital signs were stable in the operating room. Conclusion: Preoperative vital status was very important and thoracic traumatic patient should be suspected as having cardiac injury.

의료용 영상의 3차원 재구성

  • 박상희;유선국
    • 전기의세계
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    • v.38 no.8
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    • pp.32-40
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    • 1989
  • 컴퓨터기술 및 영상 공학 이론의 지속적인발달에 따른 의학적인 응용은 이제 환자의 진단적 목적을 넘어서 치료에 획기적인 역할을 담당하게 되었다. 3차원 영상이 진단적 응용외로 수술적인 목적에 적용이 되기 시작하면서 그 필요성이 임상 논문에서 발표되어지고 있으며 3차원 영상에 대한 계속적이고 응용목적에 따른 세분화된 연구가 행하여 지고 있다. 따라서 국내에서도 그간에 이룩한 공학적인 결과를 토대로 국내 의료기술의 고급화를 위하여 폭넓은 연구가 이루어 져야 하겠다. 특히 3차원 영상은 다른 영상 장비와 달리 그 응용 목적에 따라 수 많은 소프트웨어가 개발된 전망이며 그 가격도 수만불에서 수십만불에 이르는 고가이므로 이에 대한 본격적이고 신중한 연구가 기대되는 것이다.

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